Johns Hopkins Diabetes Guide
Antimicrobials with Special Precautions in Diabetes
Antimicrobials with Special Precautions in Diabetes is a topic covered in the Johns Hopkins Diabetes Guide.
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DEFINITION
- Certain antibiotics may produce undesired changes in glycemic control when used in persons with diabetes.
- No apparent interactions are described between antibiotics and insulins.
- Serum concentrations of hypoglycemic agents may change due to inhibition or induction of oxidative metabolism (i.e. cytochrome P450 system) including: meglitinides (repaglinide, nateglinide), sulfonylureas (glyburide, glimepiride, glipizide), and glitizones (pioglitazone, rosiglitazone).
- Specific cytochrome P450 substrates: repaglinide (2C8, 3A4); nateglinide (2C9>3A4); glyburide and glipizide (2C9); pioglitazone (3A4>2C8); rosiglitazone (2C8> 2C9).
- Limited number of potential drug-drug interactions observed with metformin.
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DEFINITION
- Certain antibiotics may produce undesired changes in glycemic control when used in persons with diabetes.
- No apparent interactions are described between antibiotics and insulins.
- Serum concentrations of hypoglycemic agents may change due to inhibition or induction of oxidative metabolism (i.e. cytochrome P450 system) including: meglitinides (repaglinide, nateglinide), sulfonylureas (glyburide, glimepiride, glipizide), and glitizones (pioglitazone, rosiglitazone).
- Specific cytochrome P450 substrates: repaglinide (2C8, 3A4); nateglinide (2C9>3A4); glyburide and glipizide (2C9); pioglitazone (3A4>2C8); rosiglitazone (2C8> 2C9).
- Limited number of potential drug-drug interactions observed with metformin.
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Last updated: January 5, 2017
Citation
Auwaerter, Paul. "Antimicrobials With Special Precautions in Diabetes." Johns Hopkins Diabetes Guide, 2017. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes.
Auwaerter P. Antimicrobials with Special Precautions in Diabetes. Johns Hopkins Diabetes Guide. 2017. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes. Accessed March 22, 2023.
Auwaerter, P. (2017). Antimicrobials with Special Precautions in Diabetes. In Johns Hopkins Diabetes Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes
Auwaerter P. Antimicrobials With Special Precautions in Diabetes [Internet]. In: Johns Hopkins Diabetes Guide. ; 2017. [cited 2023 March 22]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes.
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